Routine inspection·November 30, 2023

On 11/30/23 Licensing Program Analysts (LPA's) M. Garza and L. Salazar arrived at facility for an unannounced annual inspection visit. LPA's was met with Care Staff, Elaine Sauceda. LPA's introduced selves, explained reason for visit and were permitted entry into the facility. Licensee, Josiane Jones was contacted and arrived some time later. LPA's completed a health and safety check on residents in care. 3 of 3 residents observed having breakfast in the living room area. LPA's toured the facility inside and out. Pathways and doors were clear and free from obstruction. Facility was clean and without odor. Common areas were clean, adequately furnished, and adequately lit. Smoke detectors and carbon monoxide detectors were present and operational at time of visit. Fire extinguisher last serviced 8/22/23. Last fire drill on 9/16/23. 3 of 4 resident rooms observed to have the required furnishings and with adequate lighting. Linen supplies are kept in linen closets and in good repair. Sharps located in a locked laundry room closet. LPA's observed sufficient seating under covered patio areas. LPA L. Salazar completed records review. The following issues were observed at time of visit: Water temperature in bathroom #1 measured at 127.8 degrees F. Water temperature in kitchen measured at 138.7 degrees F. Food was stored in closet off the kitchen and observed to be locked. Medications were located off the kitchen in a closet and observed to be unlocked. Sign on kitchen cabinet towards living room stating "effective immediately, staff only beyond this point (no exceptions)", R1 has full bed rails, chemicals observed in hallway closet unlocked, freezer in garage needs to be defrosted, side gate #1 observed to be without latch, side gate #2 observed to be without latch and locked, right side back yard fence leaning and in need of repair. CONT... CONT... LPA's requested the following documents to be submitted to CCL by 12/7/23: current copy of Administrator’s Certificate, Administrator Organization (LIC 309), Designation of Administrative Responsibility (LIC 308), Emergency Disaster Plan (LIC 610-E), Personnel Report (LIC 500), Register of Facility Clients/Residents (LIC 9020) in order to update the facility file. The following resources were provided to Licensee: Entrance Checklist (LIC 9242), Resources for Dementia training, Training Regulation (87707), Function Capabilities Form (LIC 9172), Reappraisal regulation (87463), Medication Training Regulation (H&S 1569.9), and TSP for Hospice Care and Medication Guide, Due to time constraints LPA's will return to complete an annual continuation visit. Deficiencies (if any) will be cited at that time. Exit interview completed with Licensee and a copy of this report was provided.